Effectiveness of a motivational intervention based on spirometry results to achieve smoking cessation in primary healthcare patients: randomised, parallel, controlled multicentre study

Francisco Martin-Lujan, Josep Basora-Gallisa, Felipe Villalobos, Nuria Martin-Vergara, Estefania Aparicio-Llopis, Irene Pascual-Palacios, Antoni Santigosa-Ayala, Roxana-Elena Catalin, Cristina Rey-Reñones, Rosa Solà, ESPITAP Study Group Investigators, G Aguirre-Alava, M Altamiras-Badia, E Alvarez-Soler, C Anguera-Perpiña, V Arnau-Adan, M Baiges-Folch, J Basora-Gallisa, P Berenguer-Atrio, A Bibiloni-Sole, J Blade-Creixenti, J Blanch-Aubia, A Boada-Tous, A Borras-Gavalda, D Borras-Vicente, J J Cabre-Vila, P Camos-Guijosa, J J Canalejo-Escudero, G Cando-Guasch, M J Castellar-Salinas, R Castro-Pamies, L Comino-Sillero, S Dalmau-Vidal, M J DeAndres-DePablo, J DelPozo-Nubio, A Diego-Ferrer, J M Duran-Visiedo, T Elviro-Bodoy, J Ferrater-Cubells, J Ferre-Gras, I Fustero-Fustero, R Garcia-Aguila, C Garcia-Gonzalo, A Garcia-Masso, M Gens-Barbera, S Gil-Mancha, M D Gil-Sanchez, C Giner-Aguilo, J M Giro-Guasch, R Girona-Real, F Gomez-Santidrian, C Grau-Perez, M Grive-Isern, N Guinjoan-Aymemi, J M Hernandez-Anguera, E Hernandez-Lazaro, N Hernandez-Vidal, A Isach-Subirana, M D Jovani-Puig, M Juncosa-Cabre, A Lara-Pedrosa, M T Lara-Pedrosa, J Ledo-Garcia, M Lluis-Burgeño, A Lorente-Zozaya, M Mangrane-Ferrando, C Mangrane-Guillen, J Marimon-Barba, E Marti-Suau, A Martín-Lorente, N Martin-Vergara, M T Martinez-Blesa, T Martinez-Perez, R Mas-Escoda, M Medina-Clemente, M Mengual-Miralles, N Mora-Guilabert, A Moreno-Lagunas, Y Ortega-Vila, E Oya-Girona, L Palacios-Llamazares, M I Palma-Jimenez, J Pardo-Andujar, I Pascual-Palacios, M L Pelleja-Pellicer, M Perez-Bauer, E Perez-Galvez, T Pineda-Rigau, J L Piñol-Moreso, A Poca-Pastor, A Prats-Caellas, R Profitos-Amiell, A Reche-Martinez, V Revuelta-Garrido, C Rey-Reñones, M Ribes-Arganuy, A Riera-Sole, B Rius-Fernandez, C Rubio-Gascon, J Sabate-Mestre, R Sagarra-Alamo, I Sanchez-Oro, E Sardaña-Alvarez, N Sarra-Manetas, Y Sarre-Torra, A R Silva-Orjuela, P Soler-Barreras, R Solis-Narvaez, E Subirats-Sanz, R Subirats-Segarra, M Tersa-Alcobe, M Timon-Torres, A Urbaneja-Diez, O Vazquez-Martinez, O Vers-Lopez, M Vila-Molet, R V Vila-Rodrigo, J Vizcaino-Marin, Francisco Martin-Lujan, Josep Basora-Gallisa, Felipe Villalobos, Nuria Martin-Vergara, Estefania Aparicio-Llopis, Irene Pascual-Palacios, Antoni Santigosa-Ayala, Roxana-Elena Catalin, Cristina Rey-Reñones, Rosa Solà, ESPITAP Study Group Investigators, G Aguirre-Alava, M Altamiras-Badia, E Alvarez-Soler, C Anguera-Perpiña, V Arnau-Adan, M Baiges-Folch, J Basora-Gallisa, P Berenguer-Atrio, A Bibiloni-Sole, J Blade-Creixenti, J Blanch-Aubia, A Boada-Tous, A Borras-Gavalda, D Borras-Vicente, J J Cabre-Vila, P Camos-Guijosa, J J Canalejo-Escudero, G Cando-Guasch, M J Castellar-Salinas, R Castro-Pamies, L Comino-Sillero, S Dalmau-Vidal, M J DeAndres-DePablo, J DelPozo-Nubio, A Diego-Ferrer, J M Duran-Visiedo, T Elviro-Bodoy, J Ferrater-Cubells, J Ferre-Gras, I Fustero-Fustero, R Garcia-Aguila, C Garcia-Gonzalo, A Garcia-Masso, M Gens-Barbera, S Gil-Mancha, M D Gil-Sanchez, C Giner-Aguilo, J M Giro-Guasch, R Girona-Real, F Gomez-Santidrian, C Grau-Perez, M Grive-Isern, N Guinjoan-Aymemi, J M Hernandez-Anguera, E Hernandez-Lazaro, N Hernandez-Vidal, A Isach-Subirana, M D Jovani-Puig, M Juncosa-Cabre, A Lara-Pedrosa, M T Lara-Pedrosa, J Ledo-Garcia, M Lluis-Burgeño, A Lorente-Zozaya, M Mangrane-Ferrando, C Mangrane-Guillen, J Marimon-Barba, E Marti-Suau, A Martín-Lorente, N Martin-Vergara, M T Martinez-Blesa, T Martinez-Perez, R Mas-Escoda, M Medina-Clemente, M Mengual-Miralles, N Mora-Guilabert, A Moreno-Lagunas, Y Ortega-Vila, E Oya-Girona, L Palacios-Llamazares, M I Palma-Jimenez, J Pardo-Andujar, I Pascual-Palacios, M L Pelleja-Pellicer, M Perez-Bauer, E Perez-Galvez, T Pineda-Rigau, J L Piñol-Moreso, A Poca-Pastor, A Prats-Caellas, R Profitos-Amiell, A Reche-Martinez, V Revuelta-Garrido, C Rey-Reñones, M Ribes-Arganuy, A Riera-Sole, B Rius-Fernandez, C Rubio-Gascon, J Sabate-Mestre, R Sagarra-Alamo, I Sanchez-Oro, E Sardaña-Alvarez, N Sarra-Manetas, Y Sarre-Torra, A R Silva-Orjuela, P Soler-Barreras, R Solis-Narvaez, E Subirats-Sanz, R Subirats-Segarra, M Tersa-Alcobe, M Timon-Torres, A Urbaneja-Diez, O Vazquez-Martinez, O Vers-Lopez, M Vila-Molet, R V Vila-Rodrigo, J Vizcaino-Marin

Abstract

Objective: This 12-month study in a primary healthcare network aimed to assess the effectiveness of usual smoking cessation advice compared with personalised information about the spirometry results.

Design: Randomised, parallel, controlled, multicentre clinical trial.

Setting: This study involved 12 primary healthcare centres (Tarragona, Spain).

Participants: Active smokers aged 35-70 years, without known respiratory disease. Each participant received brief smoking cessation advice along with a spirometry assessment. Participants with normal results were randomised to the intervention group (IG), including detailed spirometry information at baseline and 6-month follow-up or control group (CG), which was simply informed that their spirometry values were within normal parameters.

Main outcome: Prolonged abstinence (12 months) validated by expired-CO testing.

Results: Spirometry was normal in 571 patients in 571 patients (45.9% male), 286 allocated to IG and 285 to CG. Baseline characteristics were comparable between the groups. Mean age was 49.8 (SD ±7.78) years and mean cumulative smoking exposure was 29.2 (±18.7) pack-years. Prolonged abstinence was 5.6% (16/286) in the IG, compared with 2.1% (6/285) in the CG (p=0.03); the cumulative abstinence curve was favourable in the IG (HR 1.98; 95% CI 1.29 to 3.04).

Conclusions: In active smokers without known respiratory disease, brief advice plus detailed spirometry information doubled prolonged abstinence rates, compared with brief advice alone, in 12-month follow-up, suggesting a more effective intervention to achieve smoking cessation in primary healthcare.

Trial registration number: NCT01194596.

Keywords: epidemiology; public health; smoking.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Screening, randomisation and follow-up of the participants (CONSORT diagram). CONSORT, Consolidated Standards of Reporting Trials.
Figure 2
Figure 2
Cumulative incidence rates of tobacco abandonment at 12-month follow-up in the intervention group and control group (analysis from Cox regression models).

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